The IAA One Minute Blog

The holiday season is upon us and you know what that means--stress. Stress and depression can ruin your holidays and your health. Insurance Administrator of America  is here with tips on how to manage holiday stress.

Helpful Holiday Reminders

It's no wonder the holiday season is stressful, as it presents a dizzying array of demands--parties, shopping, baking, cleaning, and entertaining. Here are some tips on how to deal with the multitude of issues that can occur during the holidays:

1. Be Realistic: The holidays do not have to be perfect or just like last year. As families change and grow, traditions and rituals often change as well.
2. Set Aside Differences: Try to accept friends and family members as they are, even if they don't live up to your expectations.
3. Stick to a Budget: Before you go shopping, decide how much you can spend.
4. Plan Ahead: Plan your menu and shopping list ahead of time to help prevent a last minute scramble to buy forgotten ingredients.
5. Learn to Say No: Saying yes when you should say no can leave you feeling resentful and overwhelmed.

Being realistic, planning ahead and seeking support can help ward off stress.

Dealing With Family

Sometimes it can be hard to deal with family during an already stressful time. Here are some tips for celebrating alongside family members:

• Keep Conversations Neutral: If your family wants to talk about issues you are not comfortable discussing, change the subject or excuse yourself from the room.
• Accept Who They Are: Don't try to change them, you will only get into a power struggle, cause defensiveness, invite criticism or otherwise make things worse.
• See the Best in People: Try to look for the positive aspects of others and focus on that.

Do You Have S.A.D?

Seasonal Affect Disorder (S.A.D) is a recurring depression that happens due to seasonal changes. Fall onset S.A.D, also known as "winter depression" is most recognized. In this subtype, major depressive episodes begin in late fall to early winter and decrease in summer months. It is believed decreasing daylight available in fall and winter triggers a depressive episode in people pre-disposed to develop the disorder. Symptoms of S.A.D include:

• Increased appetite
• Weight gain
• Sleep loss
• Decreased energy
• Lack of motivation
• Heavy "leaden" feeling in arms and legs
• Social withdraw

The specific causes of S.A.D remain unknown.

The Affects of Holiday Stress

One reason why stress is so recurrent during the holidays is that people fall into the same patterns year after year. Stress can be counterproductive and harmful to health even if it's only for a few weeks. While holiday stress may not cause any serious health consequences, over the long-term stress can have a negative affect on the heart.

What IAA has to Say

Don't let the holidays become something you dread. Take steps to prevent the stress and depression that can descend during the holidays. IAA wishes you and yours a happy and healthy holiday season.

The holidays might be under way, but there seems to be no rest for healthcare reform. Insurance Administrator of America has new information involving healthcare.

New Exchange Fees

On November 30, 2012, the Obama administration stated that it would charge insurance companies for the privilege of selling health insurance on the new online markets run by the federal government.

In 2014, insurers will have to pay the Department of Health and Human Services 3.5% of premiums for each plan they sell through the federal exchange. HHS Secretary, Kathleen Sebelius, said that the fees charged by the federal government would be "sufficient to cover the majority of costs related to the operation of federally facilitated exchanges". HHS said it might change the amount of its "user fee" in later years, as more people receive coverage through the exchanges.

Insurers say this new fee will be passed on to their customers.

The fees charged for the use of the federal exchange come on top of a separate annual fee to be imposed on health insurance companies to help offset the cost of expanding coverage under the new law. The annual fees to be apportioned among insurers, according to their shares of the nation's health insurance market, are expected to total $6 billion in 2014 and more than $100 billion over 10 years.

Federally run exchanges are not the only ones that can charge fees. States, like the federal government, can charge fees to insurers or they can try to raise money in other ways. Financing options include:

• Using state treasury funds
• Charging for advertising on exchange websites
• Imposing fees on insurance agents or health providers

Exchanges are supposed to be financially self-sustaining after 2014.

Expanding Medicaid

The health reform law expands Medicaid, the federal state health program for low-income citizens, but cost wary states must decide whether to take the deal. So far eight states said they would turn down the expansion, while 13 states plus the District of Columbia have indicated they will accept expansion.

Medicaid covers nearly 60 million low-income and disabled people, but differs significantly from state-to-state. Under the new law, Medicaid would expand on January 1, 2014 to cover people making up 138% of the federal poverty line or about $15,400 a year for individuals.

What IAA has to Say

IAA knows that there have been many changes in healthcare lately. IAA will stay on top of the information and keep you informed with the latest news. Remember, with IAA, one call does it all.

To read more blog posts about the PPACA click here and here.

On November 20, 2012, the Obama administration released long awaited regulations that will have an impact on the shape and the price of health coverage when the health reform law's major provisions take effect on January 1, 2014.

Equal Care for Everyone

The newly released health insurance rules are aimed at ending discrimination against the sick and guaranteeing minimum benefits for millions of Americans.

As the 2010 Healthcare Reform Law requires, insurers will no longer be able to:

• Drop patients who are becoming costly
• Charge women more than men
• Charge senior citizens more than three times the amount they charge young adults
• Use claims history, health status, gender, and occupation to increase premiums

The rules do allow insurers to charge smokers more, as well as adjust premiums based on family size and geography.

The new law seeks to protect consumers by limiting what they must pay for healthcare before insurers begin to pay. In the small group market, those deductibles are limited to $2,000 for individuals and $4,000 for family coverage.

As of 2014, non-grandfathered health plans in the individual and small group markets must meet certain actuarial values. Actuarial values are calculated as the percentage of total average costs for covered benefits that a plan will cover, i.e. if the plan has an AV of 70% then on average the consumer would be responsible for 30% of the costs of all covered benefits. The plans are given "metal values" and would cover: 60% for bronze, 70% for silver, 80% for gold, and 90% for platinum.

Essential Health Benefits

Insurance plans sold to individuals and to employers must include a core package of items and services known as "essential health benefits". To address regional inequalities in the healthcare system, the law requires insurers to provide benefits from across 10 categories in the indivudal and small group markets. The categories are:

1. Ambulatory Patient Services
2. Emergency Services
3. Hospitalization
4. Maternity and Newborn Care
5. Mental Health and Substance Use Disorder Services
6. Prescription Drugs
7. Rehabilitative and Habilitative Services
8. Laboratory Services
9. Preventative and Wellness Care and Chronic Disease Management
10. Pediatric Services (including oral and vision care)

States can choose the exact package of benefits that insurers must provide. The rules allow states to pick an existing plan as a benchmark to measure new plans. The benchmark plan can be:

1. The largest plan by enrollment in any of the three largest products in the state's small group market.
2. Any of the largest three state employee health benefit plans by enrollment.
3. Any of the largest three national Federal Employees Health Benefits Program (FEHBP) plan options by enrollment.
4. The largest insured commercial HMO in the state.

If a state doesn't select a benchmark plan, The Department of Health and Human Services will use the first option.

What IAA has to Say

The public has 30 to 60 days to comment on the proposals before the government finalizes them. If you do not believe that some of these proposed rules should be finalized, Insurance Administrator of America encourages you to voice your opinion. IAA is here to bring you the latest information on what is happening in the world of healthcare. Remember, with IAA one call does it all.

If you want to read more about the PPACA click here and here.

States now have until December 14, 2012 to declare if they are going to run their own health insurance exchanges. The Department of Health and Human Services extended the November 16, 2012 deadline due to governors declaring they need more time to make an informed decision.

What are Health Insurance Exchanges?

Health insurance exchanges are new marketplaces where individuals and small businesses will be able to shop for health insurance.

Exchanges need to be ready to start signing people and businesses up by October of 2013, for a plan year of January 1, 2014. The exchanges have to certify that the health plans offer required benefits. An estimated 12 million people are expected to receive insurance through these exchanges in 2014.

Who Will Set Up Exchanges?

Allowing states more time can be seen as a concession to the fact that many states delayed planning for exchanges. Now that President Obama has been re-elected, states need to make a decison on whether they will run their own exchanges, partner with the federal government or simply allow the federal government to run it for them.

According to the Kaiser Family Foundation, fewer than 20 states are projected to be running their own exchanges by October 1, 2013. So far nearly 30 states have not formally said what they will do. Just over a dozen states have passed legislation to take on the task without the federal government's help. Governors in another handful of states say they want no part of it.

States will have to establish rules regarding offerings and pricing, as well as meet various marketing requirements. They must also establish call centers and websites to assist businesses and individuals in choosing plans. Establishing an exchange allows states more control over which insurance plans are allowed to participate in the exchanges, how the insurance options are structured and how quality of care is measured.

Expanding Programs and Costs

Effective January 1, 2013, as Medicaid programs and providers prepare to cover more patients in 2014, the PPACA requires states to pay primary care physicians for no less than 100% of Medicaid payment rates in 2013 and 2014 for primary care services. This increase is fully funded by the federal government.

Effective January 1, 2012, tax credits to help the middle class afford health insurance will become available for those with income between 100% and 400% of the poverty line who are not eligible for affordable coverage. In 2010, 400% of the poverty line came out to about $43,000 for an individual or $88,000 for a family of four.

According to a report by HHS, compared to what they would have paid without the law:

• Middle class families purchasing private insurance in the new state-based exchange could save as much as $2,300 per year in 2014.
• In 2014, small businesses on average could save up to $350 per family policy and many may be eligible for tax credits of up to 50% of their premium.
• All businesses will likely see lower premiums of $2,000 per family by 2019.

The Healthcare Law is projected to cost (over 10 years) $940 billion. This is offset by cuts in spending and increased fees and taxes, according to the Congressional Budget Office.

What IAA has to Say

Insurance Administrator of America knows that these next few months will be a time of change. IAA will stay on top of the information and keep you informed with the latest news. Remember, with IAA, one call does it all.

To read more about the PPACA click here and here.

Nearly 26 million children and adults in the United States have diabetes. Diabetes Awareness Month is designed to focus attention on issues surrounding diabetes and those impacted by the disease.

What is Diabetes?

Diabetes is a disease that results in high levels of blood glucose (sugar). If you have diabetes, you do not make enough insulin.

Besides those who have the disease, another 79 million Americans have prediabetes and are at risk for developing type 2 diabetes. The risk factors that are associated with type 2 diabetes are:

• Having a family member with diabetes
• Being of Alaska Native, American Indian, African American, Hispanic/Latino American, Asian American or Pacific Islander descent
• Having gestational diabetes or having given birth to at least one baby weighing more than nine pounds
• Not being very physically active
• History of cardiovascular disease

According to scientists from the Centers for Disease Control, in the next four decades the number of U.S. adults with diabetes is estimated to double or triple.

Living With Diabetes

The American Diabetes Association estimates that the national cost of diagnosed diabetes in the United States is $174 billion. Here are some ways to stay healthy and cut down on those high costs:

• Meditation: Learn to meditate to help reduce stress and improve your blood sugar levels.
• Get physical: Exercise helps keep your weight and blood sugar under control.
• Travel: Before hitting the road, get a check up, pack extra meds, and plan your dosages around time zone changes.
• Weight Loss: Drop 10% of your body weight through diet and exercise.
• See Clearly: Diabetes complications can cause vision loss or blindness. Schedule an eye exam at least once a year.
• Foot Injuries: You may not feel foot injuries, so check both feet daily for blisters, cuts or sores.

Diabetes and the Holidays

Having diabetes shouldn't stop you from enjoying holiday celebrations. With some planning and work, you can stay healthy at holiday gatherings with friends and family. Here are some ways you can have those traditional favorites, but still keep your sugars in check:

1. Save Your Calories: Don't indulge on days when nothing special is going on. Save your calories for the days you are celebrating with friends and family.
2. Stick To Your Healthy Meal Plan: Bring a nutritious dish for yourself and others, to parties.
3. Avoid Overeating: If dinner is a buffet, fix your plate and move to another room. Choose smaller portions and lower calorie drinks, such as sparkling water, unsweetened tea or diet beverages.
4. Healthy Dinner Options: Choose turkey without the gravy or the skin. For side dishes, select the vegetable options. If you would like to have your favorite dessert, cut back on the other carbohydrates.
5. Help Out: Offer to help pass the goodies around. Serve everyone else, but forget to serve yourself.

At the end of the day, nothing can go into your mouth unless you put it there.

Focus on friends and family, not the food. Remember, to check your blood sugar more often than usual, because a changing schedule can affect sugar levels.

What IAA has to Say

Diabetes is treatable, but if not taken care of, could have some serious consequences. Help Insurance Administrator of America spread the word about Diabetes Awareness Month by sharing this blog post with friends and colleagues. Remember, with IAA one call does it all.

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